The Scarcity of Orthopaedic Physician Scientists

Breakthrough advances in medicine almost uniformly result from the translation of new basic scientific knowledge into clinical practice, rather than from assessment, modification or refinement of current methods of diagnosis and treatment. However, as is intuitively understood, those most responsible for scientific conception and creation-scientists - are generally not the ones applying these advances at the patient's bedside or the operating room, and vice versa. Recognition of the scarcity of clinicians with a background that prepares them to develop new basic knowledge, and to critically evaluate the underlying scientific basis of methods of diagnosis and treatment, has led to initiatives including federally funded Physician-Scientist programs, whereby young, motivated scholars begin a rigorous training, which encompasses education and mentorship within both medical and scientific fields, culminating in the conferment of both MD and PhD degrees. Graduates have demonstrated success in integrating science into their academic medical careers. However, for unknown reasons, orthopaedic surgery, more than other specialties, has struggled to recruit and retain physician-scientists, who possess a skill set evermore rare in today's increasingly complicated medical and scientific landscape. While the reasons for this shortfall have yet to be completely elucidated, one thing is clear: If orthopaedics is to make significant advances in the diagnosis and treatment of musculoskeletal diseases and injuries, recruitment of the very best and brightest physician-scientists to orthopaedics must become a priority. This commentary explores potential explanations for current low-recruitment success regarding future orthopaedic surgeon-scientists, and discusses avenues for resolution.